Surgical ring featuring a reversible diameter remote control system

Abstract

A surgical ring, designed to be implanted around biological organs comprising a pouch or a duct, so as, on the one hand, to form a closed loop between these two extremities ( 1, 2 ), thus forming a first ( 1 ) and a second ( 2 ) extremity and, on the other hand, to reduce the diameter of the opening of the organ when it is tightened by the ring, the ring including a system for reversibly controlling the variation in its diameter. The system also includes a flexible filiform element ( 4 ), inserted longitudinally with possibility of sliding into the material constituting the body of the ring between the first ( 1 ) and second ( 2 ) extremities, so as to define a fixed portion ( 5 ) connected to the first extremity ( 1 ) and a free portion ( 7 ) associated with an actuator ( 8 ) mounted on the ring near the second extremity ( 2 ).

What is claimed is: 
     
       1. Apparatus for regulating the functioning of a patient's organ or duct, comprising:
 an elongated member having first end and second ends, the elongated member having a substantially smooth, atraumatic ventral surface; 
 a clip disposed on the first end of the elongated member, the clip configured to engage the second end of the elongated member so that the elongated member forms a loop around the organ or duct; 
 a flexible element slidably disposed within the elongated member, the flexible element defining a helical screw thread; and 
 a telemetrically-controlled actuator disposed on the second end of the elongated member, the actuator having a nut that engages the helical screw thread, operation of the actuator causing the nut to draw the helical screw thread therethrough, whereby the flexible element constricts the loop against the patient's body organ or duct. 
 
     
     
       2. The apparatus of  claim 1  wherein the elongated member comprises a protective covering. 
     
     
       3. The apparatus of  claim 1  wherein the apparatus is configured for laparoscopic introduction. 
     
     
       4. The apparatus of,  claim 3  wherein the clip further comprises a tab extending from the first end of the elongated member, the tab configured to pass through and engage an aperture disposed in the second end of the elongated member. 
     
     
       5. The apparatus of  claim 1  wherein a portion of the flexible element comprises a spring. 
     
     
       6. The apparatus of  claim 5  wherein the helical screw thread comprises:
 a core wire; 
 a first helical spring disposed on the core wire, the helical spring having a square transverse profile; and 
 a second helical spring interwound with the first helical spring to define a pitch of the first helical spring and to permit flexion of the helical screw thread, while maintaining the pitch substantially constant. 
 
     
     
       7. The apparatus of  claim 1  wherein the elongated member comprises an elongated tube of compressible material that renders the ventral surface of the elongated member compressible. 
     
     
       8. The apparatus of  claim 7  wherein the compressible material is ePTFE. 
     
     
       9. The apparatus of  claim 1  wherein the telemetrically-controlled actuator further comprises:
 an electric motor coupled to the nut; 
 an antenna; and 
 an electronic circuit electrically coupled to the antenna and the electric motor. 
 
     
     
       10. The apparatus of  claim 9  wherein the antenna and electronic circuit are disposed within an elastomeric envelope. 
     
     
       11. The apparatus of  claim 10  wherein the elastomeric envelope has a substantially flat profile after subcutaneous deployment. 
     
     
       12. The apparatus of  claim 11  wherein the electronic circuitry and the antenna are collapsible. 
     
     
       13. The apparatus of  claim 2  wherein the dorsal periphery of the elongated member is reinforced to prevent diametral expansion of the dorsal periphery. 
     
     
       14. The apparatus of  claim 13  wherein a dorsal thickness of the protective envelope is greater than a ventral thickness of the protective envelope. 
     
     
       15. The apparatus of  claim 13  wherein a dorsal hardness of the protective envelope is greater than a ventral hardness of the protective envelope. 
     
     
       16. The apparatus of  claim 13  further comprising a reinforcing insert. 
     
     
       17. The apparatus of  claim 1  wherein the elongated member comprises a gastric ring designed to be implanted around a patient's stomach or esophagus. 
     
     
       18. The apparatus of  claim 1  wherein the elongated member comprises a ring designed to be implanted around the bladder or urinary tracts, or around gastro-intestinal tracts or around blood vessels. 
     
     
       19. Apparatus for gastric banding of a patient's stomach, comprising:
 an elongated member having first end and second ends, the elongated member having a compressible ventral surface and a substantially rigid dorsal periphery and configured to be formed into a loop around a portion of a patient's stomach; 
 an electric motor disposed on the second end of the elongated member; 
 a nut actuator coupled to the electric motor; 
 a flexible element slidably disposed within the elongated member, the flexible element defining a helical screw thread, the flexible element having a fixed end coupled to the first end of the elongated member and a free end that engages and extends through the nut actuator, 
 wherein operation of the nut actuator draws the helical screw thread through the nut actuator and causes the flexible element to vary a diameter of the loop. 
 
     
     
       20. The apparatus of  claim 19  wherein a portion of the flexible element further comprises a spring. 
     
     
       21. The apparatus of  claim 20  wherein the helical screw thread comprises:
 a core wire; 
 a first helical spring disposed on the core wire, the helical spring having rectangular transverse profile; and 
 a second helical spring interwound with the first helical spring to define a pitch of the first helical spring, the second helical spring having first and second ends operatively coupled to the core wire end to maintain the pitch substantially constant. 
 
     
     
       22. The apparatus of  claim 19  where the elongated member is reinforced on the dorsal periphery to prevent diametral expansion of the dorsal periphery of the elongated member. 
     
     
       23. The apparatus of  claim 22  wherein the elongated member comprises a reinforcing insert. 
     
     
       24. The apparatus of  claim 19  wherein the elongated member comprises an elongated tube of compressible material that renders the ventral surface of the elongated member compressible. 
     
     
       25. The apparatus of  claim 19  wherein the elongated member further comprises a protective covering. 
     
     
       26. The apparatus of  claim 25  wherein the protective covering provides a smooth, atraumatic surface for contacting the patient's stomach. 
     
     
       27. The apparatus of  claim 19  further comprising:
 an antenna; and 
 an electronic circuit electrically coupled to the antenna and the electric motor. 
 
     
     
       28. The apparatus of  claim 27  wherein the antenna and electronic circuit are disposed within an elastomeric envelope. 
     
     
       29. The apparatus of  claim 28  wherein the elastomeric envelope has a substantially flat profile after subcutaneous deployment. 
     
     
       30. The apparatus of  claim 29  wherein the electronic circuitry and the antenna are collapsible. 
     
     
       31. The apparatus of  claim 19  wherein the apparatus is configured for laparoscopic introduction. 
     
     
       32. The apparatus of  claim 19  further comprising a clip disposed on the first end of the elongated member, the clip configured to engage the second end of the elongated member. 
     
     
       33. The apparatus of  claim 32  wherein the clip further comprises a tab extending from the first end of the elongated member, the tab configured to pass through and engage an aperture disposed in the second end of the elongated member.